Endosleeve – Endoscopic sleeve gastroplasty with with apollo overstich: a new bariatric procedure for endoluminal bariatric surgery in high-risk and superobese patients

Einleitung:

Bariatric surgery for morbid obesity can induce important excess weight loss (EWL) during years after surgery, and co-morbidities often improve or resolve. As many patients with surgical contraindications for formal bariatric surgery have no alternative besides conservative management, new endoscopic procedures can be currently applied to these cases.

Ziele:

This study describes the preliminary german clinical experience with Endoscopic Sleeve Gastroplasty- Endosleeve.

Methodik:

Primary endoscopic sleeve gastroplasty was performed for a series of 12 patients using the full-thickness suturing device Apollo Overstich. All selected patients were ASA III classified, due to cardiopulmonary high-risk, or liver/renal transplant candidates. Technical steps included general anesthesia, insertion of an Overtube, full-thickness suturing of the corpus and fundus with interrupted nonabsorbable sutures, sizing the gastric tube. The patients were followed and documented regarding complications, weight loss and co-morbidities.

Ergebnisse:

All patients were submitted to the procedure without intraoperative complications. Mean operative time was 87 min. Mean preoperative BMI was 54 kg/m2, Highest BMI was 100, highest body weight was 310 kg. Follow-up showed satisfactory weight loss with no weight regain after 6 months. Co-morbidities were ameliorated with reduction of medications in all patients.

Schlussfolgerung:

Endoscopic primary sleeve gastroplasty using Apollo Overstich is a new non-invasive procedure for morbid obesity, satisfactory early results and no complications for this set of high-risk patients. Further studies are needed to evaluate indications of this technique as an alternative bariatric therapy.